Experts at the Women’s Cardiovascular Health Clinic at The Ohio State University Wexner Medical Center understand that the symptoms and complications of heart disease are different in women than in men. Our extensive experience treating women’s heart disease means we have unmatched expertise in Columbus. You can reduce your risk by being aware of the symptoms and risks unique to women, taking the necessary heart health precautions and seeking routine care.

“Over the last 10 years or so, we’ve learned that women’s hearts are different than men’s in some significant ways, and while that’s helped reduce mortality, there’s much more to know,” says Laxmi Mehta, MD, director of Ohio State’s Women’s Cardiovascular Health Program. “Most heart disease research is done in men, so how we categorize it is based on men. We need more science in women.”

A scientific statement issued by the American Heart Association underscores knowledge gaps that remain when it comes to women and heart attacks, and outlines the priority steps needed to better understand and treat heart disease in women. The statement, co-written by Dr. Mehta, compiles the newest data on symptoms, treatments and the types of heart attacks among women.

“We hope having one place for medical professionals to access the current data available on heart attacks in women encourages more work to implement change and close the knowledge gaps that remain,” Dr. Mehta says.

Cardiovascular disease is the leading cause of death for women in the U.S. and globally. The death rate remains higher for women than men and, despite advances, coronary heart disease remains understudied, underdiagnosed and undertreated in women. Women’s heart health experts at The Ohio State University Wexner Medical Center are leading the effort to improve awareness, prevention, recognition and treatment in women with heart disease.

To schedule an appointment with our women’s cardiology experts, call 614-293-7677.

Heart conditions

There are conditions that have special significance for women’s heart health, including: 

• Cardiovascular complications during pregnancy – These can result in cardiovascular disease. 
• Congenital heart disease and pregnancy – We have a specialist who counsels patients on the possible complications of becoming pregnant and who cares for patients with congenital heart disease through gestation and delivery. 
• Coronary microvascular disease – Also known as small vessel disease or cardiac syndrome X, this condition affects women more frequently and is often under-diagnosed. Coronary microvascular disease is a condition in which the small arteries in the heart have become narrowed. 
• Diabetes – Having this condition raises a woman’s risk of heart disease much more than it raises a man’s risk. 
• Familial hypercholesterolemia – This is a genetic disorder that results in early onset heart disease. 
• Functional amenorrhea – This condition accelerates heart disease. 
• Lupus, rheumatoid arthritis and polycystic ovarian disease – These conditions predominantly affect women and often are accompanied by heart disease. 
• Pregnancy-related complications – Gestational diabetes, preeclampsia and pregnancy-related hypertension can cause damage and effects on the heart. 
• Pulmonary hypertension – This condition disproportionately affects women. One of our physicians is devoted solely to treating women with pulmonary hypertension, a specialization found at only a handful of medical centers in the United States.

Heart attack symptoms in women

A heart attack is one serious condition that can result from heart disease. Like heart disease overall, the warning signs of a heart attack may differ in women and men. 

Both men and women experience chest pain as a primary heart attack symptom. But a woman having a heart attack may also have atypical, vague symptoms without the usual chest pain. These include: 

• Back pain 
• Coughing  
• Fatigue 
• Heart palpitations  
• Jaw pain 
• Cold sweats 
• Anxiety 
• Indigestion 
• Shortness of breath 
• Leg pain while walking (can be a symptom of peripheral arterial disease {PAD}, a predictor of heart attack and stroke)  
• Loss of appetite 
• Nausea, vomiting 
• Stroke (risk doubles if someone in your immediate family has had a stroke)  
• Weakness or dizziness

Symptoms can occur suddenly or develop over hours, days or weeks. 

Women often ignore these symptoms or attribute them to other factors. Women who have heart attacks are more likely to die from them than men because women are uninformed about the symptoms, ignore the symptoms or are reluctant to seek prompt medical attention. 

Not seeking help when symptoms of a heart attack occur can lead to permanent damage or even death. If you have symptoms of a heart attack, call 911 immediately.

Heart attack causes in women

Experts emphasize more research is needed to understand why women have different causes and symptoms of heart attacks. But there are some known sex-specific differences in causes of heart attacks.

Blocked coronary artery

In many cases, a blocked coronary artery causes a heart attack. However, women can frequently have no significant blockage, or have other types of heart attacks. An intense spasm in the artery can abruptly decrease blood flow to the heart. Women also experience spontaneous coronary artery dissection (tear in the artery) more often than men.

Social factors

Social, environmental and community differences also play a role in how women’s heart attack treatment outcomes differ from men’s. More women have depression related to heart disease, which can hinder their treatment. Women less often complete cardiac rehabilitation due to competing work and family responsibilities and lack of support.

Other risk factors

Certain cardiovascular risk factors are more potent in women, including type 2 diabetes and high blood pressure. There’s also growing evidence that emotional stress and depression can influence the onset and course of heart disease in women.

Heart disease risk factors

There are several key risk factors for heart disease and stroke: 

• Diabetes 
• Family history 
• High blood pressure 
• High cholesterol 
• Medications/supplements 
• Overweight and obesity 
• Physical inactivity 
• Smoking

Heart disease risk factors can affect women differently than men. For example, smoking and diabetes are risk factors for both men and women, but they pose a greater risk for women than men. In addition, hormone replacement therapy for women may be associated with increased risk for heart disease, blood clots and strokes.

What can women do to reduce their risk of heart disease?

• Exercise: Increase your heart rate through moderately intense exercise for 30 minutes a day, five days a week. Or increase your heart rate through vigorous cardiovascular exercise for 20 minutes a day, three days a week. 
• Avoid salt: Avoid foods that contain large amounts of added salt (sodium), including frozen dinners, cured meats and lunch meats, processed cheese, and most canned products such as soup, vegetables and pasta sauces.  
• Eat more fish: The American Heart Association recommends eating two servings of fish, particularly fatty fish (such as salmon), per week.  
• Manage stress: Set aside time to reduce your stress and do something you enjoy!

Women do have heart disease risk factors that can be prevented, such as: 

• Low-density lipoprotein (LDL) cholesterol levels 
• High blood pressure, especially if combined with obesity

After age 55, women may have higher LDL cholesterol levels than men, which increases the risk of heart disease. It’s important to have your cholesterol levels checked regularly and to take steps to keep them at safe and healthy levels. 

After menopause, women are also more likely to develop high blood pressure — a significant contributor to heart disease. Your risk for developing high blood pressure increases further if you’re also obese. 

Many women can reduce their LDL cholesterol level and blood pressure by making lifestyle changes, such as increasing physical activity and eating a heart healthy diet. If lifestyle changes alone aren’t enough to manage your cholesterol and blood pressure, your doctor may recommend medication to help.